the future of healthcare

4 trends for 2016: Experts emphasize value-based care, data-driven decisions

As the healthcare industry looks ahead at what 2016 will bring, a number of common topics are appearing on the experts’ lists and projections. Here’s a selection of subjects that industry publications and thought leaders are highlighting:

  • Mergers

Pricewaterhouse Cooper’s (PwC) Health Research Institute identifies “merger mania” as a top trend to watch for 2016, and not just among payers. The group points out that independent providers and hospitals are finding it increasingly difficult to compete in the marketplace as brand recognition becomes more important. For these providers, mergers can help them combine their strengths with others and become part of an established brand.

  • Care Outside of Hospitals

Alternative payment models, such as CMS’s upcoming bundled payments for SNFs, are incentivizing providers to design lower-cost ways of delivering care—and shifting care out of a hospital and into a post-acute facility can be very effective at lowering costs. Another idea highlighted by PwC is “bedless hospitals”—for example, Detroit Medical Center’s Children’s Hospital of Michigan, which has an ER, operating rooms, an observation unit and outpatient facilities, but no inpatient beds.

  •  Star Ratings

A key part of CMS’s aforementioned bundled payment model for SNFs is its highly preferential treatment of facilities with 3 or more stars. At least one consultant is predicting that commercial payers will eventually follow suit, “disincentivizing treatment at hospitals, nursing homes and home health agencies with fewer than 3 stars.” In this environment, healthcare organizations will need to keep a close eye on all of the factors that contribute to star ratings, including the quality of their data.

  • Data Analysis

A recent survey of health insurance executives found that 73 percent said that improving their IT capabilities would be a key component of their success in the future. The group also highlighted the importance of gaining real-time information from their data and using it to help providers make evidence-based decisions.

“The convergence of clinical, administrative, and financial data is making a huge difference,” one executive told HealthLeaders Media.

PwC echoes this point, and also offers survey data stating that 73 percent of patients said they would be willing to share their medical records with a health system to aid in the diagnosis and treatment of others. So the good news is as leaders look to use data in more creative ways, they can likely count on very willing participants in their research.

While none of these four trends are emerging as brand new topics, experts predict they’ll continue to be among the top drivers of change in 2016—and organizations that can embrace them will set themselves up for success far beyond the next year.